Effects of Lasers and Fluoride Varnish on Microhardness and Calcium and Phosphorus Content of Demineralized Enamel
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Abstract
Objectives: This study assessed the effects of blue and Er:YAG lasers, fluoride varnish, and their combination on microhardness, and calcium and phosphorus content of demineralized enamel.
Materials and Methods: The primary Vickers microhardness of 28 third molars was measured and their enamel calcium and phosphorous content was quantified by energy-dispersive X-ray spectroscopy. They were then randomly assigned to five groups of 5% sodium fluoride (NaF) varnish, 445nm blue laser, Er:YAG laser, 5% NaF + 445nm blue laser, and 5% NaF + Er:YAG laser. The teeth then underwent pH-cycling to induce caries-like lesions. The surface microhardness of the teeth and the calcium and phosphorous content of demineralized enamel were measured again. Data were analyzed by one-way ANOVA and Tukey’s test (alpha=0.05).
Results: NaF, NaF-diode laser, and NaF-Er:YAG laser groups experienced a significant increase in microhardness of demineralized enamel close to the baseline value (P<0.05). The efficacy of NaF-blue laser and NaF-Er:YAG laser was higher than NaF . In blue and Er:YAG laser groups, the mean final microhardness was significantly lower than the baseline microhardness. The percentage of phosphorus in all groups was similar to that of sound enamel. The percentage of calcium in NaF group was significantly lower than that of sound enamel and all other groups. The calcium content in other groups was similar to that of sound enamel.
Conclusion: Fluoride varnish had a synergistic effect with Er:YAG and blue lasers to increase the demineralized enamel microhardness; blue and Er:YAG lasers alone were less effective.
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7. Savas S, Kavrìk F, Kucukyilmaz E. Evaluation of the remineralization capacity of CPP-ACP containing fluoride varnish by different quantitative methods. J Appl Oral Sci. 2016 May;24:198-203.
8. Poosti M, Ahrari F, Moosavi H, Najjaran H. The effect of fractional CO 2 laser irradiation on remineralization of enamel white spot lesions. Lasers Med Sci. 2014 Jul;29:1349-55.
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10. Thurnheer T, Belibasakis GN. Effect of sodium fluoride on oral biofilm microbiota and enamel demineralization. Arch Oral Biol. 2018 May;89:77-83.
11. Ekambaram M, Itthagarun A, King NM. Comparison of the remineralizing potential of child formula dentifrices. Int J Paediatr Dent. 2011 Mar;21(2):132-40.
12. Gerard DE, Fried D, Featherstone JD, Nancollas GH. Influence of laser irradiation on the constant composition kinetics of enamel dissolution. Caries Res. 2005 Aug;39(5):387-92.
13. Verma SK, Maheshwari S, Singh RK, Chaudhari PK. Laser in dentistry: An innovative tool in modern dental practice. National J Maxillofac Surg. 2012 Jul;3(2):124-32.
14. Liu Y, Hsu CY, Teo CM, Teoh SH. Potential mechanism for the laser-fluoride effect on enamel demineralization. J Dent Res. 2013 Jan;92(1):71-5.
15. Al-Maliky MA, Frentzen M, Meister J. Artificial caries resistance in enamel after topical fluoride treatment and 445 nm laser irradiation. BioMed Res Int. 2019;2019(1):9101642.
16. Chin-Ying SH, Xiaoli G, Jisheng P, Wefel JS. Effects of CO2 laser on fluoride uptake in enamel. J Dent. 2004 Feb;32(2):161-7.
17. Zancopé BR, Rodrigues LP, Parisotto TM, Steiner-Oliveira C, Rodrigues LK, Nobre-dos-Santos M. CO 2 laser irradiation enhances CaF 2 formation and inhibits lesion progression on demineralized dental enamel—In vitro study. Lasers Med Sci. 2016 Apr;31:539-47.
18. Ana PA, Bachmann L, Zezell DM. Lasers effects on enamel for caries prevention. Laser Phys. 2006 May;16:865-75.
19. Korytnicki D, Mayer MP, Daronch M, Singer JD, Grande RH. Effects of Nd: YAG laser on enamel microhardness and dental plaque composition: an in situ study. Photomed Laser Surg. 2006 Feb;24(1):59-63.
20. Can AM, Darling CL, Ho C, Fried D. Non‐destructive assessment of inhibition of demineralization in dental enamel irradiated by a λ= 9.3‐µm CO2 laser at ablative irradiation intensities with PS‐OCT. Lasers Surg Med. 2008 Jul;40(5):342-9.
21. Zancopé BR, Cesar MM, Rodrigues LK, Nobre-dos-Santos M. Evaluation of the effect of a CO2 laser and fluoride on the reduction of carious lesions progression in primary teeth: an in vitro study. Lasers Dent. 2014 Feb; 8929:147-55.
22. Yassaei S, Motallaei MN. The effect of the Er: YAG laser and MI paste plus on the treatment of white spot lesions. J Lasers Med Sci. 2020;11(1):50.
23. Fekrazad R, Ebrahimpour L. Evaluation of acquired acid resistance of enamel surrounding orthodontic brackets irradiated by laser and fluoride application. Lasers Med Sci. 2014 Nov;29:1793-8.
24. Pandit S, Kim JE, Jung KH, Chang KW, Jeon JG. Effect of sodium fluoride on the virulence factors and composition of Streptococcus mutans biofilms. Arch Oral Biol. 2011 Jul;56(7):643-9.
25. Borggreven JM, Van Dijk JW, Driessens FC. Effect of laser irradiation on the permeability of bovine dental enamel. Arch Oral Biol. 1980 Jan;25(11-12):831-2.
26. Davari A, Daneshkazemi A, Assarzadeh H, Shafiee F. Evaluation of Er: YAG laser and fluoride ion effects on the remineralization of enamel white spot lesions. J Mashhad Dent Sch. 2018 Sep;42(3):220-10.
27. Amaechi BT, Higham SM. In vitro remineralisation of eroded enamel lesions by saliva. J Dent. 2001 Jul;29(5):371-6.
38. Yamamoto H, Sato K. Prevention of dental caries by acousto-optically Q-switched Nd: YAG laser irradiation. J Dent Res. 1980 Feb;59(2):137.
29. Maung NL, Wohland T, Hsu CY. Enamel diffusion modulated by Er: YAG laser:(part 1)—FRAP J Dent. 2007 Oct;35(10):787-93.
30. Chinelatti MA, Rocha CT, Colucci V, Serra MC, Rodrigues-Júnior AL, Corona SA. Effect of Er: Yag laser on dentin demineralization around restorations. Lasers Med Sci. 2017 Feb;32:413-8.
31. Delbem AC, Cury JA, Nakassima CK, Gouveia VG, Theodoro LH. Effect of Er: YAG laser on CaF2 formation and its anti-cariogenic action on human enamel: an in vitro study. J Clin Laser Med Surg, 2003; 21(4): 197-201.
32. Demito CF, Vivaldi‐Rodrigues G, Ramos AL, Bowman SJ. The efficacy of a fluoride varnish in reducing enamel demineralization adjacent to orthodontic brackets: an in vitro study. Orthod Craniofac Res. 2004 Nov;7(4):205-10.
33. Valizadeh S, Khub MR, Chiniforush N, Kharazifard MJ, Hashemikamangar SS. Effect of laser irradiance and fluoride varnish on demineralization around dental composite restorations. J Lasers Med Sci. 2020;11(4):450-5.
34. Mathew A, Reddy NV, Sugumaran DK, Peter J, Shameer M, Dauravu LM. Acquired acid resistance of human enamel treated with laser (Er: YAG laser and Co: 2: laser) and acidulated phosphate fluoride treatment: An: in vitro: atomic emission spectrometry analysis. Contemp Clin Dent. 2013 Apr;4(2):170-5.
35. Holcomb DW, Young RA. Thermal decomposition of human tooth enamel. Calcif Tissue Int. 1980 Dec;31:189-201.
36. Nammour S, Demortier G, Florio P, Delhaye Y, Pireaux JJ, Morciaux Y, Powell L. Increase of enamel fluoride retention by low fluence argon laser in vivo. Lasers Surg Med. 2003 Oct;33(4):260-3.
37. Robinson C, Shore RC, Brookes SJ, Strafford S, Wood SR, Kirkham J. The chemistry of enamel caries. Crit Rev Oral Biol Med. 2000 Oct;11(4):481-95.
38. Hsu CY, Jordan TH, Dederich DN, Wefel JS. Laser-matrix-fluoride effects on enamel demineralization. J Dent Res. 2001 Sep;80(9):1797-801.
39. Ceballos-Jiménez AY, Rodríguez-Vilchis LE, Contreras-Bulnes R, Alatorre JÁ, Velazquez-Enriquez U, García-Fabila MM. Acid resistance of dental enamel treated with remineralizing agents, Er: YAG laser and combined treatments. Dent Med Prob. 2018;55(3):255-9.
40. Da Cunha WA, Palma LF, Shitsuka C, Corrêa FN, Duarte DA, Corrêa MS. Efficacy of silver diamine fluoride and sodium fluoride in inhibiting enamel erosion: an ex vivo study with primary teeth. Eur Arch of Paediatr Dent. 2021 Jun;22:387-92.
2. Kermanshah H, Hashemikamangar S.S, Arami S, Mirsalehian A, Kamalinegad M, Karimi M, Jabalameli F. Comparison of antibacterial effect of hydroalcoholic extract of four plants against cariogenic microorganisms by two in vitro Methods. J Babol Univ Med Sci;13(6):21-9.
3. Llena C, Leyda AM, Forner L. CPP-ACP and CPP-ACFP versus fluoride varnish in remineralisation of early caries lesions. A prospective study. Eur J Paediatr Dent. 2015 Sep;16(3):181-6.
4. Petersson GH. Assessing caries risk--using the Cariogram model. Swed Dent J. 2003 Jan;(158):1-65.
5. Oliveira PR, Fonseca AB, Silva ED, Coutinho TC, Tostes MA. Remineralizing potential of CPP‐ACP creams with and without fluoride in artificial enamel lesions. Aust Dent J. 2016 Mar;61(1):45-52.
6. Tatevossian A. Fluoride in dental plaque and its effects. J Dent Res. 1990 Feb;69(2_suppl):645-52.
7. Savas S, Kavrìk F, Kucukyilmaz E. Evaluation of the remineralization capacity of CPP-ACP containing fluoride varnish by different quantitative methods. J Appl Oral Sci. 2016 May;24:198-203.
8. Poosti M, Ahrari F, Moosavi H, Najjaran H. The effect of fractional CO 2 laser irradiation on remineralization of enamel white spot lesions. Lasers Med Sci. 2014 Jul;29:1349-55.
9. Jones S, Burt BA, Petersen PE, Lennon MA. The effective use of fluorides in public health. Bull World Health Organ. 2005;83:670-6.
10. Thurnheer T, Belibasakis GN. Effect of sodium fluoride on oral biofilm microbiota and enamel demineralization. Arch Oral Biol. 2018 May;89:77-83.
11. Ekambaram M, Itthagarun A, King NM. Comparison of the remineralizing potential of child formula dentifrices. Int J Paediatr Dent. 2011 Mar;21(2):132-40.
12. Gerard DE, Fried D, Featherstone JD, Nancollas GH. Influence of laser irradiation on the constant composition kinetics of enamel dissolution. Caries Res. 2005 Aug;39(5):387-92.
13. Verma SK, Maheshwari S, Singh RK, Chaudhari PK. Laser in dentistry: An innovative tool in modern dental practice. National J Maxillofac Surg. 2012 Jul;3(2):124-32.
14. Liu Y, Hsu CY, Teo CM, Teoh SH. Potential mechanism for the laser-fluoride effect on enamel demineralization. J Dent Res. 2013 Jan;92(1):71-5.
15. Al-Maliky MA, Frentzen M, Meister J. Artificial caries resistance in enamel after topical fluoride treatment and 445 nm laser irradiation. BioMed Res Int. 2019;2019(1):9101642.
16. Chin-Ying SH, Xiaoli G, Jisheng P, Wefel JS. Effects of CO2 laser on fluoride uptake in enamel. J Dent. 2004 Feb;32(2):161-7.
17. Zancopé BR, Rodrigues LP, Parisotto TM, Steiner-Oliveira C, Rodrigues LK, Nobre-dos-Santos M. CO 2 laser irradiation enhances CaF 2 formation and inhibits lesion progression on demineralized dental enamel—In vitro study. Lasers Med Sci. 2016 Apr;31:539-47.
18. Ana PA, Bachmann L, Zezell DM. Lasers effects on enamel for caries prevention. Laser Phys. 2006 May;16:865-75.
19. Korytnicki D, Mayer MP, Daronch M, Singer JD, Grande RH. Effects of Nd: YAG laser on enamel microhardness and dental plaque composition: an in situ study. Photomed Laser Surg. 2006 Feb;24(1):59-63.
20. Can AM, Darling CL, Ho C, Fried D. Non‐destructive assessment of inhibition of demineralization in dental enamel irradiated by a λ= 9.3‐µm CO2 laser at ablative irradiation intensities with PS‐OCT. Lasers Surg Med. 2008 Jul;40(5):342-9.
21. Zancopé BR, Cesar MM, Rodrigues LK, Nobre-dos-Santos M. Evaluation of the effect of a CO2 laser and fluoride on the reduction of carious lesions progression in primary teeth: an in vitro study. Lasers Dent. 2014 Feb; 8929:147-55.
22. Yassaei S, Motallaei MN. The effect of the Er: YAG laser and MI paste plus on the treatment of white spot lesions. J Lasers Med Sci. 2020;11(1):50.
23. Fekrazad R, Ebrahimpour L. Evaluation of acquired acid resistance of enamel surrounding orthodontic brackets irradiated by laser and fluoride application. Lasers Med Sci. 2014 Nov;29:1793-8.
24. Pandit S, Kim JE, Jung KH, Chang KW, Jeon JG. Effect of sodium fluoride on the virulence factors and composition of Streptococcus mutans biofilms. Arch Oral Biol. 2011 Jul;56(7):643-9.
25. Borggreven JM, Van Dijk JW, Driessens FC. Effect of laser irradiation on the permeability of bovine dental enamel. Arch Oral Biol. 1980 Jan;25(11-12):831-2.
26. Davari A, Daneshkazemi A, Assarzadeh H, Shafiee F. Evaluation of Er: YAG laser and fluoride ion effects on the remineralization of enamel white spot lesions. J Mashhad Dent Sch. 2018 Sep;42(3):220-10.
27. Amaechi BT, Higham SM. In vitro remineralisation of eroded enamel lesions by saliva. J Dent. 2001 Jul;29(5):371-6.
38. Yamamoto H, Sato K. Prevention of dental caries by acousto-optically Q-switched Nd: YAG laser irradiation. J Dent Res. 1980 Feb;59(2):137.
29. Maung NL, Wohland T, Hsu CY. Enamel diffusion modulated by Er: YAG laser:(part 1)—FRAP J Dent. 2007 Oct;35(10):787-93.
30. Chinelatti MA, Rocha CT, Colucci V, Serra MC, Rodrigues-Júnior AL, Corona SA. Effect of Er: Yag laser on dentin demineralization around restorations. Lasers Med Sci. 2017 Feb;32:413-8.
31. Delbem AC, Cury JA, Nakassima CK, Gouveia VG, Theodoro LH. Effect of Er: YAG laser on CaF2 formation and its anti-cariogenic action on human enamel: an in vitro study. J Clin Laser Med Surg, 2003; 21(4): 197-201.
32. Demito CF, Vivaldi‐Rodrigues G, Ramos AL, Bowman SJ. The efficacy of a fluoride varnish in reducing enamel demineralization adjacent to orthodontic brackets: an in vitro study. Orthod Craniofac Res. 2004 Nov;7(4):205-10.
33. Valizadeh S, Khub MR, Chiniforush N, Kharazifard MJ, Hashemikamangar SS. Effect of laser irradiance and fluoride varnish on demineralization around dental composite restorations. J Lasers Med Sci. 2020;11(4):450-5.
34. Mathew A, Reddy NV, Sugumaran DK, Peter J, Shameer M, Dauravu LM. Acquired acid resistance of human enamel treated with laser (Er: YAG laser and Co: 2: laser) and acidulated phosphate fluoride treatment: An: in vitro: atomic emission spectrometry analysis. Contemp Clin Dent. 2013 Apr;4(2):170-5.
35. Holcomb DW, Young RA. Thermal decomposition of human tooth enamel. Calcif Tissue Int. 1980 Dec;31:189-201.
36. Nammour S, Demortier G, Florio P, Delhaye Y, Pireaux JJ, Morciaux Y, Powell L. Increase of enamel fluoride retention by low fluence argon laser in vivo. Lasers Surg Med. 2003 Oct;33(4):260-3.
37. Robinson C, Shore RC, Brookes SJ, Strafford S, Wood SR, Kirkham J. The chemistry of enamel caries. Crit Rev Oral Biol Med. 2000 Oct;11(4):481-95.
38. Hsu CY, Jordan TH, Dederich DN, Wefel JS. Laser-matrix-fluoride effects on enamel demineralization. J Dent Res. 2001 Sep;80(9):1797-801.
39. Ceballos-Jiménez AY, Rodríguez-Vilchis LE, Contreras-Bulnes R, Alatorre JÁ, Velazquez-Enriquez U, García-Fabila MM. Acid resistance of dental enamel treated with remineralizing agents, Er: YAG laser and combined treatments. Dent Med Prob. 2018;55(3):255-9.
40. Da Cunha WA, Palma LF, Shitsuka C, Corrêa FN, Duarte DA, Corrêa MS. Efficacy of silver diamine fluoride and sodium fluoride in inhibiting enamel erosion: an ex vivo study with primary teeth. Eur Arch of Paediatr Dent. 2021 Jun;22:387-92.
| Issue | Vol 21 (Continuously Published Article-Based) | |
| Section | Original Article | |
| DOI | https://doi.org/10.18502/fid.v21i27.16142 | |
| Keywords | ||
| Dental Enamel Tooth Demineralization Lasers Sodium Fluoride Hardness Dental Caries | ||
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Hashemikamangar SS, Merati H, Valizadeh S, Saberi S. Effects of Lasers and Fluoride Varnish on Microhardness and Calcium and Phosphorus Content of Demineralized Enamel. Front Dent. 2024;21.
